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DR. MATTIE ELIZABETH KENNEDY MD
NPI 1679364012
Internal Medicine in Augusta, GA

Active since May 15, 2025PECOS Enrolled
1469 LANEY WALKER BLVD, AUGUSTA, GA 30912(706) 721-2423 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Mattie Elizabeth Kennedy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MATTIE ELIZABETH KENNEDY MD (NPI 1679364012) is an individual internal medicine provider in Augusta, Georgia, licensed in Georgia (17657) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679364012
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. MATTIE ELIZABETH KENNEDYCredential: MD
Location Address1469 LANEY WALKER BLVDAugusta, GA 30912-0002
Mailing Address2110 Pickens St Apt 401Columbia, SC 29201-2783
Phone(706) 721-2423
Sole ProprietorYes
Enumeration DateMay 15, 2025
NPPES CertifiedMay 15, 2025
✔ NPI 1679364012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 17657
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1469 LANEY WALKER BLVD, Augusta, GA 30912
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mattie Elizabeth Kennedy Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANSLEY WILSON SMITH DO
Pediatrics
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
LESLEE MELISSA BAKER MD
Pediatrics
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
AARON T TEKLESENBET
Student in an Organized Health Care Education/Training Program
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
WILLIAM HARRIS MALOY MD
Student in an Organized Health Care Education/Training Program
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
TYLER ALUISIO
Surgery
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (762) 375-4651
RENITA ANILKUMAR PATEL
Student in an Organized Health Care Education/Training Program
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
DR. BLAKE NICHOLAS JONES MD
Emergency Medicine
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
GEORGE TOMY NARATADAM
Family Medicine
1469 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mattie Kennedy's NPI number?

The NPI number for Mattie Kennedy is 1679364012. It was assigned to this individual provider in the NPPES registry on May 15, 2025.

Where is Mattie Kennedy located?

Mattie Kennedy practices at 1469 Laney Walker Blvd, Augusta, GA 30912. The listed phone number is (706) 721-2423.

What is Mattie Kennedy's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mattie Kennedy enrolled in Medicare?

Yes. Mattie Kennedy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mattie Kennedy was last updated on May 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.